As the UK faces economic uncertainty, an ageing population and mounting pressures on the NHS, one truth stands out – investing in the nursing profession is not just a priority for the country’s health, it is an economic imperative. The government’s stated mission to drive economic growth, unlock prosperity and deliver sustainable public services will not be achieved without bold action to support the nursing profession.

As the largest part of the NHS workforce, it cannot be disputed that the nursing profession directly contributes to health outcomes, reduced mortality levels and waiting times. But when the nursing workforce is properly valued and empowered, it also supports the economy in multiple ways, including driving productivity in the wider population. When the government invests in nursing, it invests in healthier and more productive societies.

However, there continues to be a short-sighted approach to how the profession is perceived by policy makers. Nursing staff continue to be undervalued, underappreciated and underinvested in. It is now more crucial than ever for policy making and investment across government to be based on joined-up thinking. The budget this week is the perfect opportunity for just that.

Not only are nurses keeping our health and care services running, but they are also working, earning and contributing to the economy through their own consumption of goods and services. In fact, improved pay for nursing staff would create multiplier benefits in the wider economy as well as filter through in additional taxation revenues. Alongside this we know that: nursing levels improve health outcomes; that the nursing role in public health and disease prevention is vital to the health of the nation – keeping people well and economically active; and that the role of the NHS as an anchor institution will be undermined if the nursing workforce crisis does not improve. 

The invaluable contribution of the nursing profession across society is undeniable but so too are the challenges it faces. 

The number of students applying to study nursing is in decline – falling by 27% between 2021 and 2025; levels of turnover remain high – with 18% of new nurses leaving within 2 years (Nuffield Trust 2023); nurses’ sickness rates are consistently one percentage point above the pre-pandemic average and the recent NHS staff survey revealed that 45% of registered nurses and midwives felt unwell as a result of work-related stress in the past 12 months, and our own recent survey shows it is now at an eight year high.

It is for these reasons that we need to see a shift; we need to see nursing staff properly valued for the contribution they make. The fact remains that warm words of gratitude and Thursday night clapping in years gone by will only get you so far – investment is what’s needed.

This investment can start with recognising nurses as autonomous professionals.The current reality is that progression opportunities for registered nurses are currently limited to management and specialist qualifications, meaning that experienced and talented nurses are forced further away from patient care, where arguably, they are needed most. It is concerning that the knowledge, skills and experience a staff nurse accumulates over the years ceases to be recognised once they reach the top of band 5 and that despite now being a graduate career with increased NMC expectations – the current pay and career structure for nursing has not changed for decades. We know that this is impacting the profession. We also know that having nursing staff who feel valued and empowered can improve patient flow; reduce inefficiency and length of stay; and reduce turnover in other parts of the workforce.

Alongside this, nursing pay more generally has eroded dramatically over the past decade. Had wages kept pace with RPI inflation since 2011, the starting salary for a Band 5 nurse would be nearly £40,000 today. Instead, nurses have endured a 21% real-terms pay drop since 2011. The latest pay award of 3.6% falls far short of inflation and private sector norms, and has deepened dissatisfaction amongst the nursing workforce.

And to dig into this a little deeper - not only has nursing pay not kept pace with inflation or the advancements in the complexity of the profession, it also does not reflect the growing societal recognition of structural inequalities facing women and  those from the global majority, and the appetite to address them. Nursing is a highly gendered profession -  89% on the NMC register are female, while 31% are from Black and global backgrounds. Action needs to be taken to address concerns that nursing pay and career structures are inherently discriminatory.  

Nursing is crucial to the government’s economic aims and delivering the three shifts central to the Ten-Year Health Plan. The shift to community and a fully realised neighbourhood health model will not be achieved without significant investment in primary and community nursing – the decimation of this part of the workforce is well documented, most recently by the Care Quality Commission, and requires urgent attention. A whole-government commitment to addressing the wider determinants of health and properly valuing the nursing role in prevention and child health will underscore the ambition to shift from sickness to prevention. Looking ahead - nurses will be the bridge between digital innovation and patient care; and if at the centre of their design, nurses can help ensure digital tools are safe, effective, and integrated into clinical practice.

Health is the engine of prosperity, and nursing staff are its drivers. Investing in them now and protecting the nursing workforce from a worsening crisis will pay dividends for decades to come – not only in improved patient outcomes and access, but also in creating an economy fit for the future. For the government’s growth mission to be a success the Budget this week must put nursing at the heart of investment decisions.